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Tuesday, January 31, 2012

Bell's Palsy

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The trouble with Bells Palsy is that you don't know if you're having a stroke or not - and that's not a very nice position to find yourself in! All you know is that one side of your face becomes paralysed over a few hours or a few days, and the best thing you can do is to get yourself to the Doctor ASAP because with quick, appropriate treatment, the vast majority of cases will resolve: albeit, some may take months to do so.

Unlike strokes, Bell's Palsy is rare over the age of 60, and is just as rare under the age of 15: but it's not a rare condition - in a country like France there are about 15,000 new cases diagnosed each year. As well as paralysis of one side of the face which can make it impossible to smile or to close the affected side's eye, patients may also experience:

Pain around the jaw, or in or behind the ear of the affected side
Increased sensitivity to sound on the affected side
Headache
A decrease in the ability to taste
Changes in the amount of tears and saliva. This cans lead to serious drying of the affected eye.

The cause of the problem is "re-activation" of the Herpes Simplex 1 virus - the one associated with cold sores - that is found in 80% of patients with Bells. Current early treatment with steroids reduces the inflammation, caused by the virus, to the nerve as it travels through a tight bone tunnel in the base of the skull, reulting in faster resolution of the facial weakness.

But for a small minority who don't get to the Doctor early enough, or for whom steroids don't work, what options do they have?

The major obstacle facing "non responders" is that the area where the pressure is casuing the nerve damage, lies in solid bone below the brain and it's not an easy spot to get to surgically. There are some centres around the world that perform this surgery, but first they have to test the nerve to see if their is "any electrical activity" left in it. If there is, then in these specialist centres, surgical intervention offers positive results.

In Japan, they are attempting to improve surgical results by applying a Hydrogel impregnated with bFGF, a nerve regeneration stimulating factor, which has led to a significant improvement in post surgical recoveries.

I think that helping people recover from the brutal effects of a paralysed face caused by Bells Palsy is enough to make everyone smile once again!